Pseudopyloric metaplasia does not predict development of gastric cancer

Neither gastric cancer nor gastric dysplasia is seen in patients with corpus atrophic gastritis (CAG) characterized at baseline with corpus pseudopyloric metaplasia (PPM) without corpus intestinal metaplasia (IM) because such lesions are consistently associated with corpus IM, reports a study.

In addition, corpus PPM without corpus IM correlates with younger age, absence of pernicious anaemia, and severe corpus atrophy, indicating a lower stage of disease progression.

This longitudinal cohort study sought to assess the relationship between the presence of corpus mucosa PPM at baseline and the development of gastric cancer at follow-up in patients with consecutive CAG adhering to endoscopic-histological surveillance.

The investigators stratified patients for the presence or absence of corpus PPM without concomitant corpus IM at baseline and assessed the occurrence of gastric neoplastic lesions at the longest available follow-up.

Overall, 292 patients with CAG were included in the analysis, with a follow-up of 4.2 years. Corpus PPM without corpus IM was diagnosed in 62 patients (21.2 percent) at baseline.

Gastric cancer and gastric dysplasia were detected in five (1.7 percent) and four (1.4 percent) patients, respectively, at follow-up. In these patients with gastric cancer and gastric dysplasia, corpus IM was present both at baseline and at follow-up.

On the other hand, corpus PPM without corpus IM was associated with age <50 years (odds ratio, 2.5), absence of pernicious anaemia (odds ratio, 4.3), and absence of severe corpus atrophy (odds ratio, 2.3).

“Corpus PPM alone seems not to be associated with GC, whose development seems to require the presence of corpus IM as a necessary step,” the investigators said.